In Every Corner of the State, Washingtonians Rely on the Affordable Care Act for their Health

Washington state has long been a leader in improving health coverage for people of all ages. The health of our residents is threatened by Congress’s proposal to repeal the Affordable Care Act (ACA) without a replacement. Nearly 800,000 Washingtonians stand to lose their health insurance coverage through the repeal of Medicaid expansion, the end of subsidies that help Washingtonians afford coverage through the health insurance exchanges, and the likely collapse of the individual health insurance market.

A repeal of the ACA would be devastating for people in cities and towns across Washington. People and families from all backgrounds would lose the opportunity to receive preventative care, to see a doctor when they’re sick, or to have access to life-saving medications and treatments. In addition, the ACA repeal would trigger a dramatic reduction in federal funding that currently pays for health care for Washingtonians and cause job losses in health care and other sectors.

Below is a breakdown of how people would be impacted by geography and by race and ethnicity. [1]

Geography:

Because it is the most populated county in our state, King County is home to the largest number of those hurt by an ACA repeal. Over 200,000 people – or approximately a quarter of the Washingtonians who would lose coverage – live in King County. (See the map below for more information about how many people would lose coverage by county.)

Yet the loss of health coverage would be felt most significantly in rural and eastern Washington. In fact, more than 20 percent of adults of six rural counties (Grays Harbor, Jefferson, Okanogan, Pacific, Pend Oreille, and Yakima counties) currently receive health coverage through the ACA’s Medicaid expansion. [2] Further, many Washingtonians also receive subsidies to help them afford health coverage through Washington Health Plan Finder, which is part of the Affordable Care Act. So ultimately, at least 40 percent of adults rely on the ACA in six counties in our state (Adams, Franklin, Grant, Okanagan, Pacific, and Yakima).

The congressional districts with the largest percentage of residents hurt by the repeal are districts 4 and 5 in eastern Washington – which includes Spokane, Walla Walla, and the Tri-Cities.

Click on graphic to see an enlarged version of the map.

Race and ethnicity:

The majority – approximately 65 percent – of adults who would lose coverage are white. Repealing the Affordable Care Act would nevertheless disproportionately harm Black, Latino, and Asian Pacific Islander Washingtonians since approximately one in five Black, Latino, and Asian Pacific Islander adults in Washington would lose coverage, compared to approximately one in ten white adults. It is important to note that both prior to and with the Affordable Care Act, people of color are more likely to face barriers to getting health coverage due to a history of exclusionary policies, such as lower rates of employer-sponsored insurance among professions that traditionally employ more people of color.

The Affordable Care Act helped reduce racial disparities in health insurance coverage and the ACA repeal would reverse this progress. (For more information about nationwide gaps in coverage by race and ethnicity, see this Kaiser Family Foundation policy brief. )

1. Data provided by the Washington State Office of Financial Management and the Washington Health Benefit Exchange. 2.The definition of adult in this data is a person who is between 19 and 64 years old.

Our Seattle Policy Summit

You can watch our Budget Matters 2017 Seattle Policy Summit, which took place on December 6, online. The first part of the day (watch here) featured Washington State Lt. Governor Cyrus Habib and Race Forward President Glenn Harris. The second part of the day (watch here) featured Budget & Policy Center Senior Policy Analyst Jennifer Tran, and a panel of local leaders moderated by Michael Brown of the Seattle Foundation.

Our Policy Priorities

Washington state should be a place where all our residents have strong communities, great schools, and the chance for a bright future. Our 2017-2019 Legislative Agenda outlines the priorities we are working to advance to build a better Washington.

Testimonies in Olympia

To advance our legislative priorities, the Budget & Policy Center team was in the state capitol throughout session testifying on a wide range of bills. Watch our testimonies on TVW: